Health Care Fact vs Fiction: AHCA Won’t Cover ______?

We don’t usually cover politics on The Pink Armadillo. That’s because politics tend to be stressful, and we want our magazine to be a happy haven of inspiring news. That being said, we also don’t like seeing our community torn up by false narratives, propaganda, and inaccurate information. Whether you’re a conservative or a liberal, we should all want FACTS. So, we looked up the bill. We read the bill. We drank lots of coffee so our eyes could focus on the bill. We gnashed our teeth and tore our hair because the pedantic wording of the bill hurt our brains. Besides that politicians and lawyers do in fact write the driest copy on the planet, here is what we learned.

“If everyone always lies, the consequence is not that you believe the lies, but that nobody believes anything.” — Hannah Arendt

Houston’s Debra Kerner, who is running for Congress against John Culberson, posted the following on Facebook:

It reads: “Here’s a list of pre-existing conditions which will no longer be covered under #Trumpcare: AIDS/HIV, acid reflux, acne, ADD, addiction, Alzheimer’s/dementia, anemia, aneurysm, angioplasty, anorexia, anxiety, arrhythmia, arthritis, asthma, atrial fibrillation, autism, bariatric surgery, basal cell carcinoma, bipolar disorder, blood clot, breast cancer, bulimia, bypass surgery, celiac disease, cerebral aneurysm, cerebral embolism, cerebral palsy, cerebral thrombosis, cervical cancer, colon cancer, colon polyps, congestive heart failure, COPD, Crohn’s disease, cystic fibrosis, DMD, depression, diabetes, disabilities, Down syndrome, eating disorder, enlarged prostate, epilepsy, glaucoma, gout, heart disease, heart murmur, heartburn, hemophilia, hepatitis C, herpes, high cholesterol, hypertension, hysterectomy, kidney disease, kidney stones, kidney transplant, leukemia, lung cancer, lupus, lymphoma, mental health issues, migraines, MS, muscular dystrophy, narcolepsy, nasal polyps, obesity, OCD, organ transplant, osteoporosis, pacemaker, panic disorder, paralysis, paraplegia, Parkinson’s disease, pregnancy, restless leg syndrome, schizophrenia, seasonal affective disorder, seizures, sickle cell disease, skin cancer, sleep apnea, sleep disorders, stent, stroke, thyroid issues, tooth disease, tuberculosis, ulcers. Almost everyone has something.”

Unfortunately for Debra, this information is nowhere to be found in the bill itself. She does nicely consolidate a lot of the misinformation we’ve seen floating about into one post though.  However, anyone who spends 10 seconds thinking about Debra’s post should realize, “This means AHCA covers no one. Not even old white politicians.

But enough blather. Let’s get down to brass tacks.

Claim #1. Pregnancy / Prenatal Care is not covered under AHCA.
Rating: FALSE

The AHCA allocates $15 billion federal funding for maternity coverage and newborn care, on top of State funding. The bill also makes it impossible for States to impose a work requirement on pregnant women. If a pregnant woman is unemployed, she still qualifies for Medicaid nationwide. There are federal grants available to States to help cover the health care of pregnant women, children in poverty, and others. There is also additional funding set aside to help States provide, “Maternity coverage and newborn care.” (See Section 117, 121, and 132).

Claim #2. You have to be employed to get health care coverage under AHCA.

In Section 117, AHCA will “give States the option of instituting a work requirement in Medicaid for non-disabled, non-elderly, non-pregnant adults as a condition of receiving coverage under Medicaid.”

In other words, the bill does make it possible for individual states to institute work requirements, unless you are disabled, elderly, or pregnant. If you’re disabled, elderly, or pregnant, your state cannot require you to work in order to receive coverage. If you’re young, able-bodied, and not pregnant, they might. There are other stipulations in the bill as well though. For example, if you’re the parent of a disabled child under the age of 6, or you’re age 20 or younger, the head of your household, and enrolled in school, you can’t be required to work in order to be eligible for health care coverage. So yeah, work requirements are a thing, but there are a lot of exceptions.

Claim #3: AHCA denies coverage to mentally ill people and people suffering addiction. / Mental Illness is a pre-existing condition that makes people ineligible for health care.
Rating: FALSE

Federal funding is set aside to aid states as they provide, “Prevention, treatment, or recovery support services for individuals with mental or substance use disorders, focused on either or both of the following:

  • Direct inpatient or outpatient clinical care for treatment of addiction and mental illness.
  • Early identification and intervention for children and young adults with serious mental illness.”

To get really specific, AHCA allocates $15 billion for maternity coverage and newborn care, as well as the prevention, treatment, and recovery support services for individuals with mental or substance abuse disorders. (See Section 132)

Claim #4: Disabilities are pre-existing conditions / Disabled children are not covered under AHCA.
Rating: FALSE

The AHCA bill refers specifically to the continued coverage of the elderly, the blind, the disabled, and children.  It also describes federal funding provided to states with excess expenses relating to the care of elderly, blind, and the disabled.

Section 121 reads, “Each State’s targeted spending amount for children, non-expansion adults, and expansion adults would increase by the percentage increase in the medical care component of the consumer price index for all urban consumers from September 2019 to September of the next fiscal year. Each State’s targeted spending amount for elderly and blind and disabled would increase by the percentage increase in the medical care component of the consumer price index for all urban consumers from September 2019 to September of the next fiscal year plus 1 percentage point. Starting in FY2020, any State with spending higher than their specified targeted aggregate amount would receive reductions to their Medicaid funding for the following fiscal year.”

We actually sent that paragraph to a lawyer, and are waiting on a translation. However, we’re pretty sure it means:

Extra federal funding will be granted to States who need help covering children, eldery, blind, and disabled residents. However, there is a cap to how much extra funding each State can receive, and if they go over that cap, the difference may be taken out of their Medicaid funding the following year.

Like we said, we’re waiting on a translation, because, wow. It’s like it was written by Vogons.  Speaking of Vogons, we hope you appreciated our featured image, which is a screen capture from The Hitchiker’s Guide to the Galaxy. Anyone who wants to understand how bureaucracies work must watch this film or visit any DMV for any reason.

Claim #4: AHCA repeals ACA coverage of patients with breast cancer or cervical cancer.
Rating: FALSE

Despite a repeal of some Medicaid provisions, States will still be allowed to make presumptive eligibility determinations for children, pregnant women, and breast cancer and cervical cancer patients (See Section 111).

Section 212 states that certain health care funding is exempt from caps. This includes childhood vaccines, certain minorities, anyone covered under CHIP, patients of an Indian Health Services facility, breast cancer screenings and treatment, and cervical cancer screenings and treatment under the Breast and Cervical Cancer Early Detection Program.

Texas Congressman Kevin Brady released a statement responding to some of the misinformation circulating around AHCA:

“In addition to bringing choices and competition back into the individual insurance marketplaces, the legislation gives Americans the freedom to choose the health care plan that’s right for them. Today, millions of individuals and families receive help accessing affordable, quality insurance through work or a government program. But for those who don’t, AHCA provides them with a monthly tax credit that is:

  • Targeted toward low- and middle-income Americans who don’t already have access to health insurance through work or a government program.
  • Based on age and family size so as their health care needs evolve over time, so will the size of their tax credit. Individuals and families will be eligible to receive a tax credit each year between $2,000 and $14,000. Vulnerable populations, including older, low-income, or rural Americans, may be eligible for additional support through the Patient and State Stability Fund.
  • Advanceable, refundable, and credible so Americans of all walks of life—small business owners, entrepreneurs, or early retirees—can purchase a health care plan that’s right for them.

With these tax credits, individuals and families will have help paying premium costs for the major-medical plan that’s right for them—not one dictated by Washington. AHCA also provides nearly $90 billion for additional support—including enhancing the tax credit—for older Americans to access the care that meets their unique needs.”

In addition, Congressman Hal Rogers has published the following FAQ on his website:

I have a pre-existing condition. How does this bill affect me?

Under our plan, insurance companies cannot deny you coverage based on pre-existing conditions. And your health status cannot affect your premiums, unless your state asks for and receives a waiver—a condition of which is the state having other protections in place for those with pre-existing conditions. Even if your state does obtain a waiver, so long as you’ve been continuously covered, you still cannot be charged more. And the bill provides added resources to help people in waiver states who have not been continuously covered to gain coverage. Bottom line, there are many levels of protection for those with pre-existing conditions in the legislation.

I heard about the MacArthur amendment allowing states to waive protections for pre-existing conditions. If this happens, will I lose all my benefits? 
No. This amendment preserves protections for people with pre-existing conditions while giving states greater flexibility to lower premiums and stabilize the insurance market. To obtain a waiver, states will have to establish programs to serve people with pre-existing conditions. And no matter what, insurance companies cannot deny you coverage based on pre-existing conditions.

And what about the Upton amendment?
The Upton amendment provides an additional $8 billion for states seeking a waiver. These resources will allow people with pre-existing conditions who haven’t maintained continuous coverage to acquire affordable care.

Are Members of Congress exempt from this provision?
No. Members will not be exempt. This was initially included for technical reasons to comply with Senate rules, but the House is voting to fix this before voting on the AHCA.

Why are you cutting women’s health services?
We’re not. In fact, we’re expanding women’s access to health services by redirecting Planned Parenthood dollars to community health centers, which vastly outnumber Planned Parenthood clinics.

Why are you voting to kick 24 million people off health care?
We’re not. AHCA will ensure everyone has access to affordable, quality health care, but we’re just not forcing people to buy insurance. Moreover, that estimate failed to take into account other planned legislative and administrative actions, which will help bring down costs and expand coverage.


Refundable tax credits are an important component of the AHCA, designed to give people who don’t receive health care at work the same tax benefits as those who do so they can purchase the kind of coverage that is right for their family. It equalizes the tax treatment of health care regardless of where you buy it and helps create a vibrant individual market. These credits are longstanding conservative policy goals.


One in three physicians are unwilling to accept new Medicaid patients. Unfortunately, Obamacare simply added more people to a broken system. The AHCA is a historic shift of power back to the states so that we can make it work for those who need it. It reforms Medicaid so that it is flexible and responsive to those it was created to serve.

It prohibits states from expanding into the current broken Medicaid system.

It maximizes state flexibility. It gives states the choice between a per capita allotment or a traditional block grant and provides the option for states to implement work requirements for Medicaid recipients.

It ensures the rug isn’t pulled from underneath any able-bodied patient as he or she transitions to other coverage, like a plan purchased with refundable tax credits.


Health Savings Accounts (HSAs) are tax-free health care savings accounts for Americans with high-deductible health plans. HSAs are critical for helping Americans save and spend their health care dollars more wisely.

The AHCA would nearly double the amount Americans can contribute to their accounts, which will give greater choice and flexibility in purchasing coverage. Conservatives agree: HSAs must be a focal point of health care reform.


First and foremost, the bill contains numerous protections for people with pre-existing conditions. The law is clear: Under no circumstance can people be denied coverage because of a pre-existing condition. The latest draft contains two more layers of security for these individuals:

The MacArthur amendment gives flexibility to states to tackle premium prices. However, there is a very strict process for obtaining that waiver. It will only be given to states with high-risk pools and other protections in place.

For states seeking a waiver, the Upton amendment provides an additional $8 billion to allow people with pre-existing conditions who haven’t maintained continuous coverage acquire affordable care.


The AHCA defunds Planned Parenthood, the largest abortion provider in the country, for one year by blocking more than $500 million of federal dollars. It redirects the money to community health centers, which far outnumber Planned Parenthood clinics.

CLICK HERE to read Ways and Means Committee Chairman Brady’s statement on AHCA.

CLICK HERE to read a summary of AHCA.

CLICK HERE to read the section-by-section of AHCA.

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